The Next Frontier of Kidney Care
We are entering an exciting time of research, discovery and innovation surrounding the kidney care landscape. Although the path from scientific breakthrough to approved therapy takes time, researchers and institutions around the world are making discoveries that could translate into meaningful advances in kidney treatments down the road.
We’ve collected a few examples of fascinating initiatives which may one day alter the care of people with kidney disease, and we think they’re worth following.
Getting to Know the Kidney Better by Exploring the Human Genome1,2
Recent developments in understanding the human genome—specifically, the genes associated with kidney function—will have a huge impact on the ability to assess the risk of kidney disease and develop more effective treatments.
Researchers are continuing to discover more areas of the human genome (the entire set of genetic information that makes us who we are) that are associated with kidney function or development. Their work is confirming other parts of the genome that are already associated with the estimated glomerular filtration rate (eGFR). The eGFR rate measures the performance level of tiny filters in our kidneys—how well they’re working to remove excess fluid and waste from the blood—in addition to being used to screen for, and detect, early kidney damage and chronic kidney disease (CKD). Many of these newly-discovered areas in the genome were associated with eGFR in people with type 2 diabetes or high blood pressure, populations at especially high risk for CKD.
We’re particularly excited about the potential for better diagnosis of CKD and other conditions that may lead to CKD because around 90 percent of people with CKD don’t even know they have it. This is a patient group often diagnosed too late, and in many cases dialysis is the only option at that point, despite effective therapies being available to help in the earlier stage of disease.
“We’re particularly excited about the potential for better diagnosis of CKD…
because around 90 percent of people with CKD don’t even know they have it.”
The Role of Stem Cells3,4
Induced pluripotent stem cells (iPSCs) are adult cells that have been genetically reprogrammed to work like embryonic stem cells. Basically, they’re cells of an early-stage preimplantation embryo that haven’t yet started to form into the tissues and organs of a human. Scientists are able to take these cells and direct them to become kidney cells.
This is an exciting concept because it may be eventually possible to rebuild a new kidney for a patient from their own cells, reducing the chance of their body rejecting an organ transplant.
Wearable and Implantable Technologies
Portable personal electronics and wearable technologies are already completely woven into many of our lives—from smartphones and smart watches to fitness trackers. These technological innovations are also making their way into the healthcare space and have the potential to significantly change the way CKD patients are treated.
Researchers are in the process of developing a wearable artificial kidney. The University of Washington Medicine is collaborating with the FDA to test the effectiveness of a light-weight, battery-powered artificial kidney that clips onto a belt worn by the patient. Not only would this free patients from being ‘tethered’ to dialysis centers, it could also offer more consistent and regular treatment, and potentially lead to more efficient ways for doctors and patients to share data and communicate between office visits.5
Meanwhile, researchers at Vanderbilt University Medical Center have created the world’s first artificial kidney that can be powered by a patient’s own heart. The key to this unique concept is a multi-layered microchip that has pores programmed to act as filters designed to mimic the function of a real kidney. As the heart pumps, blood moves through the microchip implanted in the patient’s artery and is filtered much like it would moving through a kidney. Clinical studies are scheduled to start toward the end of 2017.6
Planning for the Future
For the millions of patients affected by kidney disease and related conditions, these advances offer hope of prevention and better treatments. Technology, access to robust sets of data, and the diligence of inventive minds are opening up a world of possibilities that may soon become reality. It’s an exciting time for healthcare, and we’re looking forward to seeing these remarkable developments unfold.
1. Mining the Genome for Insights into Kidney Function and Develpoment. National Institute of Diabetes and Digestive and Kidney Disease. https://www.niddk.nih.gov/news/research-updates/Pages/mining-genome-insights-kidney-function-development.aspx Accessed September 30, 2016.
2. Tuot, D; Plantinga, L; Hsu, C; Jordan, R; Burrows, N; Hedgman, E; Yee, J; Saran, R; Powe, N. Chronic Kidney Disease Awareness Among Individuals with Clinical Markers of Kidney Dysfunction. August 2011. Clin J Am Soc Nephrol. 6(8): p. 1838-1844.
3. Stem Cells Represent a New Area of Kidney Care. Nephrology News & Issues. http://www.nephrologynews.com/ips-cells-represent-new-area-kidney-care/ Accessed September 30, 2016.
4. Francipane, MG; Lagasse, E. Pluripotent Stem Cells to Rebuild a Kidney: The Lymph Node as a Possible Development Niche. 2016. Cell Transplant. 25(6): p. 1007-23.
5. Wearable Artificial Kidney to be Tested for Safety and effectiveness in Collaboration with FDA. UW Today. University of Washington. http://www.washington.edu/news/2012/04/09/wearable-artificial-kidney-to-be-tested-for-safety-and-effectiveness-in-collaboration-with-fda/ Accessed September 30, 2016.
6. Wolf, A. VU Inside: Dr. William Fissell’s Artificial Kidney. Vanderbilt University. https://news.vanderbilt.edu/2016/02/12/vu-inside-dr-william-fissell%E2%80%99s-artificial-kidney/ Accessed September 30, 2016.